doctor doctor July 12, 2007

I went to the doctor’s office yesterday for my recent stomach woes. In his relatively bare office, where I waited for him to arrive, 3 items hung on the walls. Two were certificates for specialist of the year from some medical society I’d never heard of. The other one, which hung above his desk and formed the focal point of the room was a BMI chart. This BMI chart was large, with a black background. Like most, it had an axis of heights and an axis of weights. “Normal” height/weight ratios formed a grey block. “Overweight” was an orange block of comparable size. “Obese” took up nearly 3/5ths of the chart, and was colored bright-danger-red. Curiously, there was no section marked “underweight” although I can say with certainty that many New Yorkers are. I guess anorexia is not a concern for the CDC. The aphorism “you can never be too thin or too rich” comes to mind.

I trace my height and weight, to discover that I am fortunate enough to be considered “normal” by the medical establishment. So why do I still feel so uncomfortable? The easy quantification of my whole body into a number, which can only be “okay,” “bad” or “very bad”? The front-and-center placement of the chart, which greets the patient before the doctor does? The fact that something relatively meaningless can be so meaning-laden? The poster speaks for the doctor. It says, “before you see me, check to see if you’re fat.” Why is it there? If it made me as uncomfortable as it did, I can only imagine how a larger person would feel about seeing it, how it would color their whole visit.

My girlfriend and I got into an argument about whether it was appropriate for a doctor (a gastroenterologist) to have that poster in his office. She seemed to think he chose it because it was free, made his office look “professional” (doctorial?) and informed patients of where they stand. I wouldn’t give him the benefit of the doubt on this. There aren’t many meanings a poster like this can have in a gastroenterologist’s office. Any patient who sees it in that context can pretty easily connect the dots.

Aside from the fact that it would make fat patients uncomfortable and felt judgmental to me, I’m not even clear on who this chart is supposed to benefit. Fat people know they’re fat. They are reminded of it every day, implicitly and, with alarming frequency, explicitly. Is the chart there to delineate to them whether they are “obese” or merely “overweight”? Is it there to guilt them before their meeting with the doctor? To, quite literally, let them know where they stand? Thin people probably know they’re thin; and anyways, they’re not even represented on this chart. Perhaps it’s there to allow “normal” people the comfort of knowing they aren’t overweight? Yet, somehow, I doubt this – the bright red color of the “fat zone” contravenes this hunch and suggests a quite opposite meaning.

Although I’ve never been told by a doctor to lose weight (granted, I rarely go to the doctor unless it’s absolutely necessary, which for me totals at less than once a year,) I have a number of friends who have. One was a fairly slim girl who, I suspect, would actually fall on the cusp of normal/underweight according to the BMI chart. When she had her annual checkup, the nurse at the health center told her she had high cholesterol and to lose oh, about 10 pounds. When asked why, the nurse told her that, in their experience, people who weight less have lower cholesterol. Riiight. Nice and easy. It certainly wasn’t the weekly hamburgers she was fond of eating. No, it was because she weighed too much. I actually cannot imagine what this girl would look like were she to lose the requisite weight, but the words “scary” and “unhealthy” come to mind. Another girl had a similar experience when she went in to get birth control. Unsolicited advice to drop 10-15lbs from the doctors and nurses at this health center. Again, if these “normal” girls are getting this kind of care, you don’t need to think too hard to envision what fat women (and men, though, I suspect, to a lesser extent) have to put up with from health care providers.

Like this:

I wrote this same story last week on FatFu’s blog, so I’m sorry to bore those who have read this before, but it’s pertinent to your post here. Sorry if it’s a bit long!

At the age of 13 I was 5′ tall and 115 lbs. I was tiny and very flat-chested from the waist up and had big hips and thighs. My family treated me like I was very fat and an embarrasment to them. My class-mates focused on “ugly” a lot, but strangely enough, not fat, and I recall at the time there were some very fat kids in my class who were popular, including girls. I saw a doctor for a check-up, he was a huge man, clearly over 300 lbs, but when I weighed in at 115, he started going on to my mother about how fat I was and that she must be a terrible mother to have let me get so fat and out of shape. I guess the last straw was reading a story for class, which ironically was suppose to be a cautionary tale about the dangers of anorexia. The “heroine” was constantly referred to (well before she because anorexic I guess) as “chubby” “pudgy” with lines along the order of “As her schoolmates called her fatty-fat-fat tears streamed down her pudgy cheeks.” What was our fictional, soon-to-be anorexic’s size? 5′ tall and 115 lbs!!!

Shortly after that I decided that I was kidding myself if I thought I wasn’t really fat, and losing the weight became my main priority in life. I started starving myself and living off of nothing but a liquid diet. I used all types of speed, including cocaine. I became a chain-smoker. The more weight I lost the lower my self-esteem seemed to sink, because somehow it could never really be enough, and even if it were, I would still be “ugly.”

Anyway, by the time I was almost 16 I was weighing in at 98lbs. I didn’t even know until I went to the doctor, because I was too scared to ever weigh myself, I was frightened of myself, if it came in too high I might do something harmful to myself as a punishment for not being thinner. When the doctor (a different one) saw my weight at 98 lbs, he gave me a big smile and said “Your weight is perfect! If only I saw more young women who take care of themselves like you do!”

So being a healthy growing 115 lbs girl was “unhealthy” and made my mother “irresponsible” but being under 100 lbs and crazed on speed made me “perfect” and young woman who “takes care of” herself.

thanks so much for sharing your story. it sadly yet perfectly illustrates how fucked up and superficial our some doctors’ idea of health is. i am routinely baffled at how ignorant they can be, considering that they are some of the most trained and highest paid professionals in this country. i might forgive a layperson for believing everything they hear and not questioning the fat=unhealthy or fat=death, but it’s pretty unacceptable from a highly educated medical professional.